Provider Demographics
NPI:1528951415
Name:SCOTT GRALLA ACUPUNCTURE LLC
Entity type:Organization
Organization Name:SCOTT GRALLA ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GRALLA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:516-987-1926
Mailing Address - Street 1:2 CORNFIELD LN
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-2702
Mailing Address - Country:US
Mailing Address - Phone:516-987-1926
Mailing Address - Fax:
Practice Address - Street 1:755 PULASKI RD
Practice Address - Street 2:
Practice Address - City:GREENLAWN
Practice Address - State:NY
Practice Address - Zip Code:11740-1710
Practice Address - Country:US
Practice Address - Phone:631-754-4333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty